Abstract

BIDOLEGUI, Fernando; PEREIRA, Sebastián  and  VINDVER, Gabriel. Rescate de osteosíntesis intertrocantéricas y subtrocantéricas fallidas con un reemplazo articular: Técnica y resultados de una serie de 61 casos. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2018, vol.83, n.2, pp.85-93. ISSN 1852-7434.

Introduction: The aim of this study was to review technical issues of hip arthroplasty after a failed proximal femur fixation, as well as to evaluate results and complications associated with this procedure. Methods: Sixty-one hip arthroplasties after a failed intertrochanteric or subtrochanteric fixation were performed. Average age of patients was 76 years (range 50-93). Thirty-four patients (56%) were originally treated with a dynamic hip screw, 8 (13%) with a DCS, 2 (3%) with Ender nail and 17 (28%) with proximal femoral nail. Fifty-five patients (90%) were treated with total hip arthroplasty and 6 (10%) with hemiarthroplasty. Uncemented stem was used in 17 patients (28%) and a cemented stem in 44 (72%). A standard length stem was used in 12 patients, and a long stem in 49 cases. Results: The HHS improved from 47 (range 32-54) before surgery to 84 (range 67-93) at one-year follow-up. Seven patients (11.5%) had complications: 3 (4.9%) periprosthetic femoral fractures, 2 (3.2%) dislocations, one (1.6%) wound hematoma, and one (1.6%) deep infection. Conclusions: Hip arthroplasty after a failed fixation of an intertrochanteric or subtrochanteric fracture is an effective method. Pain and functional outcomes improve significantly in most patients. However, it is a more technically challenging procedure and causes more complications than primary hip replacement.

Keywords : Failed osteosynthesis; Proximal femur; Hip arthroplasty.

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